My daughter and I both have T1 and we both use a pump & CGM, but we don’t use the same pump*. I have been using the Omnipod since I started pumping in 2006-ish** and so have never used a tubed pump for myself. When the Bear was diagnosed and both we & her medical team wanted to get her pumping ASAP (shots and a picky toddler eater are a very hard combination), we decided to go with the Medtronic (she uses the Revel) pump for her. The amount of “real estate” you need for a Medtronic site is considerably smaller than that for the Omnipod (even though actual cannula size is basically the same***) which makes a big difference on a small body. Also, the endo practice had the most experience (and had good experience) with Medtronics & little kids so I was happy to follow that recommendation.
A pretty steep learning curve commenced. The theory of dosing insulin using a pump is the same, but everything else about using two different pumps is not. I despaired of ever being able to do a quick site change on the Bear as I sat there with the instructions for Mio sets, painstakingly following the step-by-step notes. Finding things in the Medtronic menus was almost comical for me. Of course at this point, 3+ years of changing sites every other day and changing settings more often than changing shoe sizes (which happens incredibly often in growing kids – what is up with that?), I can walk someone through pretty much anything over the phone without hardly thinking about it (“Press ACT three more times then it will start counting up as it delivers the insulin”).
There’s always more to learn though… I’m starting to wish we could branch out some for sites for the Bear and since she is adamant about not using her abdomen (which doesn’t leave many options), I’m seeking out other alternatives. I know lots of folks use their arms (which we use for her CGM so I know it’s a possibility) and legs (untested territory for us) but I’m having trouble figuring out how that is going to work with the tubing. I saw this Loop post on Twitter today about trying a new site location on the arm and it does mention the need to consider the tubing (“The tubing length really matters in this case since the tubing now has to reach from my arm, around my shoulder, and down to my pocket where I typically clip my pump.”). But I still can’t picture how this would work in practice.
When I am trying to figure out a potential new site for the Pod, I just try it out. I mostly use abdomen, but have used legs, lower back, arms… It’s not that easy with the Bear. It’s also harder for me to tell how important it is to try new site locations. On myself, sometimes it just feels like an area is getting overused. We are very good about rotating within the area we use on her, and her doc/cde haven’t seen any problems yet. Still, they always ask me if we have tried here or there and I know that eventually we will need to branch out. I also know that whatever we try, the tubing issue is likely to make a difference to her. She already gets irritated with the tubing now and has even torn out a site once or twice herself in a fit of pique over it****.
In so many ways I feel lucky to have T1 myself when it comes to managing the Bear’s diabetes — I already knew how to carb count, had experience with making changes to pump settings, etc. I have no advantage when it comes to other things though (like devices that I don’t myself use) and have no IRL friends to ask at this point. So, I need my DOC friends… what sites do you use for tubed pumps and tell me specifically what you do with the tubing!
*We do however use the same CGM – the Dexcom G4
**I can never remember when I started using various medical devices
***Disclaimer – I have no facts handy about actual size of the cannulae for these two devices. The difference does seem to be that with the Omnipod, the entire “pump” sits on top of the insertion point while with the Medtronic you just have the connector bit and the adhesive
****Admission: I secretly hope this means that she will want to switch to the Omnipod when her warranty is up. I don’t work for Insulet or write for them or anything, just love my pump 🙂